CommercialAdministrativeHigh impact
Requirement to refer members to in-network providers for all BCBSRI products
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
May 1, 2021
We identified it
Jun 19, 2026
Summary
BCBSRI-contracted providers must now refer all members exclusively to in-network providers for services including durable medical equipment, radiology, behavioral health, and laboratory services. Three specific laboratories (Total Toxicology, U.S. Lab & Radiology Inc., and Quest Diagnostics) are explicitly excluded from BCBSRI's network.
Action Required
Immediately: All providers must verify network participation status before establishing referrals using BCBSRI's Find a Doctor tool. Stop referring BCBSRI members to Total Toxicology, U.S. Lab & Radiology Inc., and Quest Diagnostics. Update referral processes to require network verification for all durable medical equipment, radiology, behavioral health, and laboratory services. Train staff on mandatory use of Find a Doctor tool for referral verification.